ICECAP-A Instrument

Agreement for use of the ICECAP-A (ICEpop CAPability) Instrument for adults.

The ICECAP-A Instrument is a measure of capability for all adults. It has been developed in the UK using in-depth and semi-structured qualitative research with adults over the age of 18; values for the UK obtained using best-worst scaling are available. The instrument contains five attributes (stability, attachment, autonomy, achievement, and enjoyment), each with four levels.

Research on the instrument’s validity, reliability, feasibility of use and sensitivity to change are still ongoing.

The developers of ICECAP-A are, in principle, happy for the instrument to be used by other researchers interested in contributing to the study of the instrument’s properties in particular patient and client groups. Agreement to use the instrument is on the basis that:

  • the instrument is not altered in any way, in terms of the nature of attributes, the wording of attributes, the levels of attributes, or the values provided by the research team.
  • information resulting from research studies is made available (upon request) for the purposes of assessing validity, reliability, feasibility of use and sensitivity to change, if this was not the primary aim of the study (i.e. if this information is not published by the user).
  • use of the instrument is registered and is not for commercial gain

If you would like to use the instrument, please return a signed copy of this agreement, giving details of your study, and indicating that you wish to use the ICECAP-A instrument. We will contact you indicating our agreement for you to use the ICECAP-A instrument in the named study.

If your needs go beyond those outlined here – for example, if you wish to use the ICECAP-A instrument in a country outside the UK and thus are unsure about the applicability of wording in your country or if you will need to develop a new translation of the instrument, please contact the developers of ICECAP-A to explore the possibility of conducting further developmental research collaboratively.

Please complete all sections below:
Name of Principal Investigator (PI):
PI’s Institution:
Contact name:
Contact email address:
Postal address:
(Including country)
Study name:
Funding body:
Study start date:
Expected end date:
Please summarise the main study objectives, methodologies, patient/participant characteristics, and any interventions/comparators:
Age demographic of the patient/participant population (please tick all that apply): / <18
18-64
>65
Please list all countries within which data collection will occur:
FOR USE IN NON-ENGLISH LANGUAGE CONTEXTS ONLY
Will you be using an existing translation of ICECAP-A? / NO
YES
(please specify)
Do you wish to translate ICECAP-A into a new language? / NO
YES (Please specify)
I/we have read the document “Using the ICECAP capability measures in non UK/English-speaking contexts” / Please tick to confirm:
I/we will send a copy of the back-translation to for approval, prior to commencing data collection: / Please tick to confirm:

We would like to use the ICECAP-A instrument for the purposes outlined in the agreement above and agree to the conditions of use as specified. Completion of this form constitutes agreement to abide by the terms of use outlined in the Agreement for the use of the ICECAP-A Instrument

I am a non-commercial user and use of the instrument will be for academic purposes (please tick) 

Principal Investigator: ...... (Signature)

...... (Name)

...... (Date)

Please return completed form to:

Dr Philip Kinghorn, Health Economics Unit, Public Health Building, University of Birmingham, Birmingham, B15 2TT. E-mail: